This report draws on more than 250 peer-reviewed scientific studies,  discussions with a panel of medical and environmental experts, and qualitative findings from interviews with Iowans who shared their experiences. The report examines the associations between environmental risk factors and cancer incidence and trends across Iowa. The breadth of data and information gathered from personal stories told by Iowans and publicly available research offers strong evidence that specific environmental exposures are associated with specific cancer types in Iowa. The conclusions reached in the report are grounded in data that reflects how environmental factors intersect with Iowa’s cancer trends.